What is the role of surgery in the treatment of chronic kidney disease (CKD) in children?

Updated: Jul 21, 2020
  • Author: Sanjeev Gulati, MD, MBBS, DNB(Peds), DM, DNB(Neph), FIPN(Australia), FICN, FRCPC(Canada); Chief Editor: Craig B Langman, MD  more...
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Answer

Surgical intervention is often recommended in children with obstructive uropathy to relieve acute kidney failure due to initial or recurrent obstruction. These children should be provided follow-up because, despite surgical intervention, they have persistent underlying chronic kidney disease (CKD). In those children who opt for hemodialysis, an arteriovenous fistula needs to be created by the vascular surgery team as an access for hemodialysis.

The following images depict diagrams of major, intermediate, and minor predictors that may be used in the perioperative management of patients with chronic renal failure.

Minor clinical predictors to be used for the perio Minor clinical predictors to be used for the perioperative management of a patient with chronic renal failure. ECG = electrocardiogram; METs = metabolic equivalents of task.
Intermediate clinical predictors to be used for th Intermediate clinical predictors to be used for the perioperative management of a patient with chronic renal failure. CHF = congestive heart failure; METs = metabolic equivalents of task; MI = myocardial infarction.
Major clinical predictors to be used for the perio Major clinical predictors to be used for the perioperative management of a patient with chronic renal failure. CHF = congestive heart failure.

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